Gordon K A, Tanaka S, Wong D D E, Papsin B C
The Cochlear Implant Program, The Cochlear Implant Laboratory, Room 6D08, The Hospital for Sick Children, 555 University Avenue, Toronto, Ont., Canada M5G 1X8.
Clin Neurophysiol. 2008 Oct;119(10):2347-62. doi: 10.1016/j.clinph.2008.06.013. Epub 2008 Aug 26.
To determine if cortical responses evoked by a cochlear implant in children who are deaf differ from normal and to characterize these differences in children who achieve good versus fair speech perception outcomes post-implantation.
Late latency-evoked potential responses were recorded at 28 scalp locations in 16 children who were deaf from infancy and experienced cochlear implant users. Speech perception measures indicated that 8 had good scores and 8 had fair scores. In each child, responses were evoked by 36ms electrical pulse trains delivered from a single-implant electrode at the apical and basal ends of the array and by 36ms tone bursts (0.5, 2, and 6kHz). Responses to the tone bursts were also recorded in 14 age-matched children with normal hearing.
We found (1) a dominant positive wave in all implant users and (2) a larger than normal negative amplitude peak in users with fair speech perception scores which had similar scalp topography to N1 but did not show the expected changes in amplitude with stimulus frequency.
Late latency-evoked potential responses in children using cochlear implants reflect abnormal and/or immature patterns of cortical activity.
Limitations in auditory skills with a cochlear implant in children may be due to developmental processes in the cortex which are either slow to mature or which mature abnormally.
确定人工耳蜗植入对聋儿诱发的皮层反应是否与正常情况不同,并对植入后言语感知结果良好与一般的儿童之间的这些差异进行特征描述。
对16名自幼失聪且使用人工耳蜗的儿童,在28个头皮部位记录晚期潜伏期诱发电位反应。言语感知测量结果显示,8名儿童得分良好,8名儿童得分一般。对每个儿童,通过从阵列顶端和基部的单个植入电极发送的36毫秒电脉冲序列以及36毫秒的短音(0.5、2和6千赫)诱发反应。还对14名年龄匹配的听力正常儿童记录了对短音的反应。
我们发现(1)所有植入使用者中均有一个优势正波,以及(2)言语感知得分一般的使用者中存在一个比正常情况更大的负向波峰,其头皮地形图与N1相似,但未表现出预期的随刺激频率的振幅变化。
使用人工耳蜗的儿童的晚期潜伏期诱发电位反应反映了皮层活动的异常和/或不成熟模式。
儿童人工耳蜗听觉技能的局限性可能是由于皮层发育过程成熟缓慢或异常成熟所致。